The effect of reducing EEG electrode number on the visual interpretation of the human expert for neonatal seizure detection.

Abstract

OBJECTIVES:

To measure changes in the visual interpretation of the EEG by the human expert for neonatal seizure detection when reducing the number of recording electrodes.

METHODS:

EEGs were recorded from 45 infants admitted to the neonatal intensive care unit (NICU). Three experts annotated seizures in EEG montages derived from 19, 8 and 4 electrodes. Differences between annotations were assessed by comparing intra-montage with inter-montage agreement (K).

RESULTS:

Three experts annotated 4464 seizures across all infants and montages. The inter-expert agreement was not significantly altered by the number of electrodes in the montage (p = 0.685, n = 43). Reducing the number of EEG electrodes altered the seizure annotation for all experts. Agreement between the 19-electrode montage (K19,19 = 0.832) was significantly higher than the agreement between 19 and 8-electrode montages (dK = 0.114; p < 0.001, n = 42) or 19 and 4-electrode montages (dK = 0.113, p < 0.001, n = 43). Seizure burden and number were significantly underestimated by the 4 and 8-electrode montage (p < 0.001). No significant difference in agreement was found between 8 and 4-electrode montages (dK = 0.002; p = 0.07, n = 42).

CONCLUSIONS:

Reducing the number of EEG electrodes from 19 electrodes resulted in slight but significant changes in seizure detection.

SIGNIFICANCE:

Four-electrode montages for routine EEG monitoring are comparable to eight electrodes for seizure detection in the NICU.

• Authors: Nathan J Stevenson, Leena Lauronen, Sampsa Vanhatalo
• Journal: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology (Clin Neurophysiol) Vol. 129 Issue 1 Pg. 265-270 (01 2018) ISSN: 1872-8952 [Electronic] Netherlands
• PMID: 29223823 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Topics

• Electrodes
• Electroencephalography (instrumentation, methods, standards)
• Female
• Humans
• Infant, Newborn
• Male
• Observer Variation
• Spasms, Infantile (diagnosis, physiopathology)